Frequently Asked Questions1. Which doctor should I consult for cataract?
You should consult an eye doctor (ophthalmologist).
2. Can glasses correct a cataract?
Sometimes, a cataract may be associated with changes in the refractive index of the lens and can induce a refractive error. That part of the vision that is impaired because of the refractive error can be corrected by glasses.
3. Is cataract surgery safe?
Yes, cataract surgery is by and large safe and has a success rate of 98%. Various complications are possible, and sometimes unfortunate incidents do happen, as with any surgical procedure.
4. Can having cataract surgery cause glaucoma?
Temporary rises in intraocular pressure are common after cataract surgery and can be brought under control by the short term use of anti-glaucoma medication. Rarely, a sudden rise of intraocular pressure can occur due to a blockage of the drainage angle by a swollen ciliary body or blockage of the pupil. These can be reversed by appropriate timely medical or laser intervention. Long term use of corticosteroid eye drops after cataract surgery can result in steroid induced glaucoma. Glaucoma is much more common after infant cataract surgery.
5. How long does it take to recover from cataract surgery?
Recovery from cataract surgery takes just a couple of days in most cases. You can read and watch TV after the surgery if you are comfortable with it. You can resume cooking after a couple of days as long as you are not exposed to strong vapors and fumes. You may bathe the next day, but water should not get in to your eyes for up to 2-4 weeks. Eye makeup should be avoided for at least 3 to 4 weeks, though it is better to consult your doctor before you start using it again. Activities like driving, heavy exercise and swimming will have to be postponed for up to 2-4 weeks. You can go back to work in a couple of days unless you are involved in heavy strenuous work or are exposed to dust or chemical fumes. You can drive as soon as your vision clears up, or if you have good vision in your other eye - confirm this with your doctor. Do not rub your eyes for at least a month after surgery.
6. What will happen if a cataract is left untreated?
With nuclear and posterior subcapsular cataracts, there will a progressive diminution of vision which can hinder day-to-day activities. However, a cortical cataract can become mature or hypermature, which in addition to loss of vision, can lead to complications like phacomorphic glaucoma, phacolytic glaucoma, lens-induced uveitis and lens displacement. The eye becomes red and painful, and the outcomes may be less than perfect when operated under these conditions.
7. Is it dangerous to delay cataract surgery?
That depends on the stage of the cataract. A mature, hypermature and swollen cataract needs to be operated as soon as possible to avoid dangerous complications. Other types can be delayed without fear of complications; however surgery is required for visual recovery.
8. Does one still need to wear glasses after cataract surgery?
If a monofocal intraocular lens has been placed, then only distance vision is corrected. The person needs to wear glasses for near tasks such as reading. However if a multifocal intraocular lens has been implanted, then near tasks can be achieved satisfactorily in most cases without glasses. Sometimes, some amount of residual refractive error may be present. This may be due to pre-existing astigmatism, surgically-induced astigmatism, tilting or displacement of intraocular lens. Glasses need to be used in these conditions. The first two conditions may also be treated with incisions made at the junction of the cornea and sclera either with a blade or a laser, and the latter 2 conditions may need surgical manipulation if severe.
9. Does cataract need to be mature for surgery?
No. The criterion today for surgery is visual disability. If the cataract that is present is making performance of any task difficult, then such a cataract may be operated upon.
10. Is there an age limit for cataract surgery?
No, a cataract can be operated upon at any age.
No, the intraocular lens will remain unaltered in the eye and does not react with body tissue nor does it disintegrate.
12. I have cataracts in both my eyes. Can both of my eyes be operated upon on the same day to save on post-operative recovery time?
It is always better to undergo surgery in both eyes in 2 separate sittings. This is to ensure that any inadvertent infection does not affect both eyes simultaneously. A gap of 1-2 days between the surgeries of the two eyes is acceptable, provided there are no complications in the first eye.
13. My doctor says I need cataract surgery. However I have been having short-sight since childhood. Can this be corrected too?
Yes. Most pre-existing refractive errors are taken care of by taking certain measurements before the surgery and adjusting the power of the intraocular lens that is to be placed in the eye.
14. Is laser cataract surgery done without making an incision in the eye?
No. The eye is still opened, as the laser takes care of only some steps of the surgery. Moreover, an opening is mandatory to remove the cataractous lens and to implant the intraocular lens.
15. I have undergone cataract surgery. Can I still donate my eyes after death?
Yes, you can. As long as the cornea is clear and healthy, it can be used for corneal transplantation.
16. Do cataracts move in the eye?
Cataracts do not normally move in the eye. However, if the zonules (the fibers that anchor the lens in place) are weakened or disrupted either due to injury or hypermaturity of the lens or some other disease condition, then the lens may be partially or completely displaced.
17. If I undergo cataract surgery in one eye, do I have to undergo surgery in the other eye also?
No. You will require surgery only if you have a vision disabling cataract in the other eye.
18. Do I have to get admitted for cataract surgery?
Not in most cases. You can go to the hospital on the morning of the surgery, and go home soon after the procedure is over. However, if you have some medical conditions that need monitoring then you may have to be admitted for a day or two either before or after the surgery.
19. What is an after cataract? Can I have a recurrence of cataract after surgery?
Cataract cannot recur after surgery. However you may develop an after cataract (or PCO – posterior capsule opacification) which is a clouding of the posterior capsule of the lens (which is left behind during the surgery so that it acts as scaffolding for placement of the intraocular lens). When this happens, vision becomes poor after a couple of weeks to months of good vision. An after cataract can be treated by a simple laser procedure known as YAG laser capsulotomy, wherein an Nd:YAG (Neodymium: Yttrium Aluminium Garnet) laser is used to make an opening in the posterior capsule thus making the visual axis clear again. This procedure takes just a couple of minutes and is entirely painless.
20. I am taking tamsulosin for prostate enlargement. Will there be a problem during surgery?
Tamsulosin is known to cause a problem known as IFIS (intraoperative floppy iris syndrome) in cataract surgery. Discuss this with your eye doctor, so that he may recommend a non-selective alpha-blocker such as doxazosin or alfuzosin as a replacement for a short period of time.
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Shantived Institute of Medical Sciences, Sikandra